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Medical condition
Hypovolemic shock
A diagram showing the formation of interstitial fluid from the bloodstream
Specialty
Emergency care
Symptoms
Anxiety, confusion, decreased or no urine output, cool and clammy skin, sweating, weakness, pallor, rapid breathing, unconsciousness[1]
Causes
Severe dehydration or blood loss
Treatment
Replacement of fluids, surgery to repair cause of bleeding
Hypovolemic shock is a form of shock caused by severe hypovolemia (insufficient blood volume or extracellular fluid in the body).[1][2] It could be the result of severe dehydration through a variety of mechanisms or blood loss.[3][2] Hypovolemic shock is a medical emergency; if left untreated, the insufficient blood flow can cause damage to organs, leading to multiple organ failure.[4]
In treating hypovolemic shock, it is important to determine the cause of the underlying hypovolemia, which may be the result of bleeding or other fluid losses. To minimize ischemic damage to tissues, treatment involves quickly replacing lost blood or fluids, with consideration of both rate and the type of fluids used.[4]
Tachycardia, a fast heart rate, is typically the first abnormal vital sign.[3] When resulting from blood loss, trauma is the most common root cause, but severe blood loss can also happen in various body systems without clear traumatic injury.[3] The body in hypovolemic shock prioritizes getting oxygen to the brain and heart, which reduces blood flow to nonvital organs and extremities, causing them to grow cold, look mottled, and exhibit delayed capillary refill.[3] The lack of adequate oxygen delivery ultimately leads to a worsening increase in the acidity of the blood (acidosis).[3] The "lethal triad" of ways trauma can lead to death is acidosis, hypothermia, and coagulopathy.[3] It is possible for trauma to cause clotting problems even without resuscitation efforts.[3]
Damage control resuscitation is based on three principles:
permissive hypotension: tries to balance temporary suboptimal perfusion to organs with conditions for halting blood loss by setting a goal of 90 mmHg systolic blood pressure [3]
hemostatic resuscitation: restoring blood volume in ways (with whole blood or equivalent) that interfere minimally with the natural process of stopping bleeding.[5]
damage control surgery.[3]
^ ab"Hypovolemic shock: MedlinePlus Medical Encyclopedia". MedlinePlus. 2019-01-28. Retrieved 2019-02-21.
^ abMcGee, Steven (2018). Evidence-based physical diagnosis. Philadelphia, PA: Elsevier. ISBN 978-0-323-39276-1. OCLC 959371826. The term hypovolemia refers collectively to two distinct disorders: (1) volume depletion, which describes the loss of sodium from the extracellular space (i.e., intravascular and interstitial fluid) that occurs during gastrointestinal hemorrhage, vomiting, diarrhea, and diuresis; and (2) dehydration, which refers to the loss of intracellular water (and total body water) that ultimately causes cellular desiccation and elevates the plasma sodium concentration and osmolality.
^ abTaghavi, S; Askari, R (2018), "article-28977", Hypovolemic Shock, Treasure Island (FL): StatPearls Publishing, PMID 30020669, retrieved 2019-02-20
^Cap, Andrew P.; Gurney, Jennifer M.; Meledeo, Michael A. (2020). "Hemostatic Resuscitation". Damage Control Resuscitation. pp. 117–144. doi:10.1007/978-3-030-20820-2_7. ISBN 978-3-030-20819-6. S2CID 242142361.
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excessive and rapid losses of volume may lead to hypovolemicshock. Signs and symptoms of hypovolemicshock include increased heart rate, low blood pressure...
(hypotensive). There are 4 main types of shock: hypovolemic, distributive, cardiogenic, and obstructive. Hypovolemicshock is caused by low blood volume (hypovolemia)...
reaction is very similar to the treatment of cardiogenic shock, vascular shock, and hypovolemicshock; that is, allowing the patient to lie down, providing...
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level of consciousness. This is called hemorrhagic or hypovolemicshock, which is a type of shock that occurs when there is not enough blood to reach organs...
in the volume of blood within the body, which is known as hypovolemicshock. Hypovolemicshock can be life-threatening as it can very quickly starve the...
hypertensive states. Shock is when the body does not have adequate circulation to provide oxygen to body tissues. Hypovolemicshock occurs due to low circulating...
in evaluating shock. This occurs in cardiogenic and obstructive shock. This is not observed in the other two types of shock, hypovolemic and distributive...
plasma from the capillaries results in extreme low blood pressure and hypovolemicshock; Patients with severe plasma leakage may have fluid accumulation in...
cardiovascular drug. In India, it is approved for the treatment of hypovolemicshock. Centhaquine is a vasopressor acting on α2A- and α2B-adrenoreceptors...
oxygen diffusion from arterial blood to tissues. hypoperfusion (e.g., hypovolemicshock) causing an inadequate blood delivery of oxygen to tissues. A rise...
lacerations and appreciable blood loss, and it probably set the stage for hypovolemicshock, as evidenced by the fact that Jesus was too weakened to carry the...
endotoxins (the septic form). This can lead to life-threatening hypovolemicshock and septic shock, and requires intensive care including antibiotics. Nontyphoidal...
including uterine hypertonus, fetal distress, fetal death, and rarely, hypovolemicshock (shock secondary to severe blood loss). The uterus may adopt a bluish/purplish...
"Use of the Trendelenburg Position to Improve Hemodynamics During HypovolemicShock". BestBets. Terai C, Anada H, Matsushima S, Kawakami M, Okada Y (1996)...
decreased output of urine may be a sign of dehydration, kidney failure, hypovolemicshock, hyperosmolar hyperglycemic nonketotic syndrome (HHNS), multiple organ...
death. This system is basically the same as used in the staging of hypovolemicshock. Individuals in excellent physical and cardiovascular shape may have...
Additional non-cardiac causes include hemorrhage, aortic rupture, hypovolemicshock, pulmonary embolism, poisoning such as from the stings of certain...
potential to accumulate fluids in the space has specific consequences. Hypovolemicshock can occur in patients where severe blood loss occurs and fills the...
such conditions unmaintained blood volume could lead to hypovolemicshock (hypovolemicshock could lead to damage of body organs e.g. kidney, brain, or...
symptoms such as abdominal distension, tenderness, peritonism and hypovolemicshock. Someone with a ruptured ectopic pregnancy may experience pain when...
life-threatening complication of adrenal insufficiency. Hypotension, or hypovolemicshock, is the main symptom of adrenal crisis. Other symptoms include weakness...
station on manual vaginal exam. Intra-abdominal bleeding can lead to hypovolemicshock and death. Although the associated maternal mortality is now less...
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